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    Childhood Extracranial Germ Cell Tumors Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Treatment of Malignant Gonadal GCTs in Children

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    Standard treatment options for malignant testicular GCTs in postpubertal males

    Refer to the PDQ summary on Testicular Cancer Treatment for more information about the treatment of malignant testicular GCTs in postpubertal males.

    Current Clinical Trials

    Check for U.S. clinical trials from NCI's list of cancer clinical trials that are now accepting patients with childhood malignant testicular germ cell tumor. The list of clinical trials can be further narrowed by location, drug, intervention, and other criteria.

    General information about clinical trials is also available from the NCI Web site.

    Childhood Malignant Ovarian GCTs

    Most ovarian neoplasms in children and adolescents are of germ cell origin.[1] Ovarian GCTs are very rare in young girls, but the incidence begins to increase in children aged approximately 8 or 9 years and continues to rise throughout adulthood.[1]

    Childhood malignant ovarian GCTs can be divided into germinomatous (dysgerminomas) and nongerminomatous malignant GCTs (i.e., yolk sac carcinomas, mixed GCTs, choriocarcinoma, and embryonal carcinomas).

    (Refer to the Mature Teratomas [Nonsacrococcygeal Sites] section of this summary for more information about childhood mature and immature teratomas arising in the ovary and the PDQ summary on Ovarian Germ Cell Tumors Treatment for more information on the treatment of ovarian GCT in postpubertal females.)

    Dysgerminomas of the ovary

    Standard treatment options for dysgerminomas of the ovary

    Standard treatment options for dysgerminomas of the ovary include the following:

    1. Surgery and observation (stage I).
    2. Surgery and chemotherapy (stages II through IV).

    The treatment options for dysgerminomas of the ovary differ by stage of disease.

    Stage I

    For stage I ovarian dysgerminomas of the ovary, cure can usually be achieved by unilateral salpingo-oophorectomy, conserving the uterus and opposite ovary, and close follow-up observation.[8,15,16,17,18]

    Chemotherapy may be given if tumor markers do not normalize or if tumors recur.

    Stages II through IV

    While advanced-stage ovarian dysgerminomas, like testicular seminomas, are highly curable with surgery and radiation therapy, the effects on growth, fertility, and risk of treatment-induced second malignancy in these young patients [19,20] make chemotherapy a more attractive adjunct to surgery.[21,22] Complete tumor resection is the goal for advanced dysgerminomas; platinum-based chemotherapy can be given preoperatively to facilitate resection or postoperatively (after debulking surgery) to avoid mutilating surgical procedures.[18] This approach results in a high rate of cure and the preservation of menstrual function and fertility in most patients with dysgerminomas.[21,23]

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